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Fan L, Yu M, Pinkham A, Zhu Y, Tang X, Wang X, Zhang X, Ma J, Zhang J, Zhang X, Dai Z. Aberrant large-scale brain modules in deficit and non-deficit schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 2022; 113:110461. [PMID: 34688810 DOI: 10.1016/j.pnpbp.2021.110461] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 10/16/2021] [Accepted: 10/18/2021] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Schizophrenia is a heterogenous psychiatric disease, and deficit schizophrenia (DS) is a clinical subgroup with primary and enduring negative symptoms. Although previous neuroimaging studies have identified functional connectome alterations in schizophrenia, the modular organizations in DS and nondeficit schizophrenia (NDS) remain poorly understood. Therefore, this study aimed to investigate the modular-level alterations in DS patients compared with the NDS and healthy control (HC) groups. METHODS A previously collected dataset was re-analyzed, in which 74 chronic male schizophrenia patients (33 DS and 41 NDS) and 40 HC underwent resting-state functional magnetic resonance imaging with eyes closed in a Siemens 3 T scanner (scanning duration = 8 min). Modular- (intramodule and intermodule connectivity) and nodal- [normalized within-module degree (Zi) and participation coefficient (PCi)] level graph theory properties were computed and compared among the three groups. Receiver operating characteristic curve (ROC) analyses were performed to examine the classification ability of these measures, and partial correlations were conducted between network measures and symptom severity. Validation analyses on head motion, network sparsity, and parcellation scheme were also performed. RESULTS Both schizophrenia subgroups showed decreased intramodule connectivity in salience network (SN), somatosensory-motor network (SMN), and visual network (VN), and increased intermodule connectivity in SMN-default mode network (DMN) and SMN-frontoparietal network (FPN). Compared with NDS patients, DS patients showed weaker intramodule connectivity in SN and stronger intermodule connectivity in SMN-FPN and SMN-VN. At the nodal level, the schizophrenia-related alterations were distributed in SN, SMN, VN, and DMN, and 7 DS-specific nodal alterations were identified. Intramodule connectivity of SN, intermodule connectivity of SMN-VN, and Zi of left precuneus successfully distinguished the three groups. Partial correlational analyses revealed that these measures were related to negative symptoms, general psychiatric symptoms, and neurocognitive function. CONCLUSION Our findings suggest that functional connectomes, especially SN, SMN, and VN, may capture the distinct and common disruptions of DS and NDS. These findings may help to understand the neuropathology of negative symptoms of schizophrenia and inform targets for treating different schizophrenia subtypes.
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Affiliation(s)
- Linlin Fan
- Department of Psychology, Sun Yat-sen University, Guangzhou, Guangdong, China; School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX, United States
| | - Miao Yu
- Department of Neurology, Affiliated Nanjing Brain Hospital, Nanjing Medical University, No. 264 Guangzhou Road, Nanjing, Jiangsu, China
| | - Amy Pinkham
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX, United States
| | - Yiyi Zhu
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX, United States
| | - Xiaowei Tang
- Department of Geriatric Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Psychiatry, Affiliated WuTaiShan Hospital of Medical College of Yangzhou University, Yangzhou, Jiangsu, China
| | - Xiang Wang
- Medical Psychological Institute of the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xiaobin Zhang
- Department of Psychiatry, Affiliated WuTaiShan Hospital of Medical College of Yangzhou University, Yangzhou, Jiangsu, China
| | - Junji Ma
- Department of Psychology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Jinbo Zhang
- Department of Psychology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Xiangrong Zhang
- Department of Geriatric Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, Jiangsu, China.
| | - Zhengjia Dai
- Department of Psychology, Sun Yat-sen University, Guangzhou, Guangdong, China.
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Anomalous self-experiences are related to general cognition deficits in schizophrenia. Eur Arch Psychiatry Clin Neurosci 2021; 271:707-712. [PMID: 33221938 DOI: 10.1007/s00406-020-01213-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 11/07/2020] [Indexed: 12/29/2022]
Abstract
Anomalous self-experiences (ASEs) are prevalent in schizophrenia, but its underpinnings are not completely understood. Given the likely complex substrate of the experience of the self, neurocognitive functions requiring coordinate cerebral activity may relate to ASEs. Moreover, cognitive deficits functioning may be involved in the link between self-experience disturbances and some aspects of social dysfunction in schizophrenia. We have assessed ASEs in 41 schizophrenia patients (11 first episodes) using the Inventory of Psychotic-Like Anomalous Self-Experiences (IPASE), and the general cognition using the Brief Assessment of Cognition in Schizophrenia (BACS). Besides, social cognition was assessed using two complementary tools Meyer, Salovey and Caruso Emotional Intelligence Test (MSCEIT) and GEOPTE (Grupo Español para la Optimización del Tratamiento de la Esquizofrenia). The results revealed that Self-awareness/presence and Somatization IPASE scores were inversely explained by motor speed in the BACS; Consciousness IPASE scores were inversely explained by problem solving performance in the BACS. These data reveal a significant relationship between certain domains of general cognition and anomalous self-experiences, that may be useful in further investigation on the substrates of ASEs.
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Sullivan CR, Koene RH, Hasselfeld K, O'Donovan S, Ramsey A, McCullumsmith RE. Neuron-specific deficits of bioenergetic processes in the dorsolateral prefrontal cortex in schizophrenia. Mol Psychiatry 2019; 24:1319-1328. [PMID: 29497148 PMCID: PMC6119539 DOI: 10.1038/s41380-018-0035-3] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 12/07/2017] [Accepted: 01/15/2018] [Indexed: 12/20/2022]
Abstract
Schizophrenia is a devastating illness that affects over 2 million people in the United States and costs society billions of dollars annually. New insights into the pathophysiology of schizophrenia are needed to provide the conceptual framework to facilitate development of new treatment strategies. We examined bioenergetic pathways in the dorsolateral prefrontal cortex (DLPFC) of subjects with schizophrenia and control subjects using western blot analysis, quantitative real-time polymerase chain reaction, and enzyme/substrate assays. Laser-capture microdissection-quantitative polymerase chain reaction was used to examine these pathways at the cellular level. We found decreases in hexokinase (HXK) and phosphofructokinase (PFK) activity in the DLPFC, as well as decreased PFK1 mRNA expression. In pyramidal neurons, we found an increase in monocarboxylate transporter 1 mRNA expression, and decreases in HXK1, PFK1, glucose transporter 1 (GLUT1), and GLUT3 mRNA expression. These results suggest abnormal bioenergetic function, as well as a neuron-specific defect in glucose utilization, in the DLPFC in schizophrenia.
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Affiliation(s)
- Courtney R. Sullivan
- Corresponding author: , Phone number: 513-558-4855, Mail address: 231 Albert Sabin Way, Care 5830, Cincinnati, Ohio, 45267-2827
| | - Rachael H. Koene
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH
| | - Kathryn Hasselfeld
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH
| | - Sinead O'Donovan
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH
| | - Amy Ramsey
- Department of Pharmacology and Toxicology, University of Toronto, ON, Canada
| | - Robert E. McCullumsmith
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH
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Kim JH, Kim JH, Son YD, Joo YH, Lee SY, Kim HK, Woo MK. Altered interregional correlations between serotonin transporter availability and cerebral glucose metabolism in schizophrenia: A high-resolution PET study using [ 11C]DASB and [ 18F]FDG. Schizophr Res 2017; 182:55-65. [PMID: 27760700 DOI: 10.1016/j.schres.2016.10.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Revised: 10/10/2016] [Accepted: 10/12/2016] [Indexed: 11/19/2022]
Abstract
The purpose of the present study was to investigate the patterns of interregional correlations of serotonin transporter (SERT) availability with glucose metabolism using 7-Tesla magnetic resonance imaging (MRI) and high-resolution positron emission tomography (PET) with 11C-3-amino-4-(2-dimethylaminomethylphenylthio)benzonitrile ([11C]DASB) and [18F]fluorodeoxyglucose ([18F]FDG) in antipsychotic-free patients with schizophrenia in order to shed new light on the disrupted functional connectivity in schizophrenia. Nineteen patients with schizophrenia and 18 healthy controls underwent high-resolution PET and MRI. The binding potential (BPND) of [11C]DASB and standardized uptake value ratio (SUVR) of [18F]FDG were obtained. In SERT availability, the region of interest (ROI)-based analyses showed no significant group differences in any region, except for the anterior hippocampus where the SERT availability was lower in patients with schizophrenia than in controls. The ROI- and voxel-based analyses revealed that the [18F]FDG SUVR values were significantly lower in patients than in controls in the right superior frontal gyrus and medial part of the left superior frontal gyrus. Regarding the interregional correlations of [11C]DASB BPND with [18F]FDG SUVR, more widespread positive correlations across the brain regions were observed in control subjects than in patients with schizophrenia. Notably, the patients and control subjects showed statistically significant differences in correlations between the SERT availability in the parietal and temporal cortices and the glucose metabolism in the posterior cingulate cortex. These results suggest abnormal functional connectivity between the higher-order cortical regions in schizophrenia and a possible important role of the posterior cingulate gyrus and its related circuitry in the pathophysiology of schizophrenia.
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Affiliation(s)
- Jeong-Hee Kim
- Research Institute for Advanced Industrial Technology, Korea University, Sejong, Republic of Korea; Neuroscience Research Institute, Gachon University, Incheon, Republic of Korea
| | - Jong-Hoon Kim
- Neuroscience Research Institute, Gachon University, Incheon, Republic of Korea; Department of Psychiatry, Gachon University Gil Medical Center, Gachon University School of Medicine, Incheon, Republic of Korea.
| | - Young-Don Son
- Neuroscience Research Institute, Gachon University, Incheon, Republic of Korea; Department of Biomedical Engineering, College of Health Science, Gachon University, Incheon, Republic of Korea
| | - Yo-Han Joo
- Neuroscience Research Institute, Gachon University, Incheon, Republic of Korea
| | - Sang-Yoon Lee
- Neuroscience Research Institute, Gachon University, Incheon, Republic of Korea; Department of Radiological Science, College of Health Science, Gachon University, Incheon, Republic of Korea
| | - Hang-Keun Kim
- Neuroscience Research Institute, Gachon University, Incheon, Republic of Korea; Department of Biomedical Engineering, College of Health Science, Gachon University, Incheon, Republic of Korea
| | - Myung-Kyun Woo
- Department of Electrical and Computer Engineering, Seoul National University, Seoul, Republic of Korea; Center for Magnetic Resonance Research, University of Minnesota Medical School, Minneapolis, USA
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FDG-PET scans in patients with Kraepelinian and non-Kraepelinian schizophrenia. Eur Arch Psychiatry Clin Neurosci 2016; 266:481-94. [PMID: 26370275 DOI: 10.1007/s00406-015-0633-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Accepted: 08/11/2015] [Indexed: 01/01/2023]
Abstract
We recruited 14 unmedicated patients with Kraepelinian schizophrenia (12 men and 2 women; mean age = 47 years old), 27 non-Kraepelinian patients (21 men and 6 women; mean age = 36.4 years old) and a group of 56 age- and sex-matched healthy volunteers. FDG positron emission tomography and MRI scans were coregistered for both voxel-by-voxel statistical mapping and stereotaxic regions of interest analysis. While both Kraepelinian and non-Kraepelinian patients showed equally lower uptake than healthy volunteers in the frontal lobe, the temporal lobes (Brodmann areas 20 and 21) showed significantly greater decreases in Kraepelinian than in non-Kraepelinian patients. Kraepelinian patients had lower FDG uptake in parietal regions 39 and 40, especially in the right hemisphere, while non-Kraepelinian patients had similar reductions in the left. Only non-Kraepelinian patients had lower caudate FDG uptake than healthy volunteers. While both patient groups had lower uptake than healthy volunteers in the medial dorsal nucleus of the thalamus, Kraepelinian patients alone had higher uptake in the ventral nuclei of the thalamus. Kraepelinian patients also showed higher metabolic rates in white matter. Our results are consistent with other studies indicating that Kraepelinian schizophrenia is a subgroup of schizophrenia, characterized by temporal and right parietal deficits and normal rather than reduced caudate uptake. It suggests that Kraepelinian schizophrenia may be more primarily characterized by FDG uptake decreased in both the frontal and temporal lobes, while non-Kraepelinian schizophrenia may have deficits more limited to the frontal lobe. This is consistent with some neuropsychological and prognosis reports of disordered sensory information processing in Kraepelinian schizophrenia in addition to deficits in frontal lobe executive functions shared with the non-Kraepelinian subtype.
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Hazlett EA, Lamade RV, Graff FS, McClure MM, Kolaitis JC, Goldstein KE, Siever LJ, Godbold JH, Moshier E. Visual-spatial working memory performance and temporal gray matter volume predict schizotypal personality disorder group membership. Schizophr Res 2014; 152:350-7. [PMID: 24398009 DOI: 10.1016/j.schres.2013.12.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Revised: 11/27/2013] [Accepted: 12/05/2013] [Indexed: 10/25/2022]
Abstract
BACKGROUND Prior work shows individuals with schizotypal personality disorder (SPD) evince temporal lobe volume abnormalities similar to schizophrenia but sparing of prefrontal cortex, which may mitigate psychosis and the severe neurocognitive impairments observed in schizophrenia. This study examined the extent to which frontal-temporal gray matter volume and neurocognitive performance predict: (1) SPD group membership in a demographically-balanced sample of 51 patients and 37 healthy controls; and (2) symptom severity in SPD. METHODS Dimensional gray-matter volume (left frontal-temporal regions (Brodmann area (BA) 10, 21, 22)) and neurocognitive performance on key memory tasks (California Verbal Learning Test (CVLT), Dot Test, Paced Auditory Serial Addition Test (PASAT)), all salient to schizophrenia-spectrum disorders were examined in a multi-variable model. RESULTS Middle temporal gyrus (BA21) volume and spatial-working memory (Dot Test) performance were significant predictors of SPD group membership likelihood, with poorer working-memory performance indicating increased probability of SPD membership. Combining across regional volumes or cognitive measures resulted in fair-to-good discrimination of group membership, but including neurocognitive and non-collinear regional volume measures together resulted in a receiver-operating-characteristic (ROC) curve with improved diagnostic discrimination. Larger BA10 volume in dorsolateral prefrontal cortex (DLPFC) significantly predicted less symptom severity in SPD. CONCLUSIONS These findings suggest that temporal lobe volume and spatial-working memory performance are promising biological/phenotype markers for likelihood of SPD classification, while greater DLPFC volume may serve as a protective factor.
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Affiliation(s)
- Erin A Hazlett
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Mental Illness Research, Education, and Clinical Center (MIRECC VISN 3), James J. Peter Veterans Affairs Medical Center, Bronx, NY, United States; Research & Development, James J. Peters Veterans Affairs Medical Center, Bronx, NY, United States.
| | - Raina V Lamade
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Mental Illness Research, Education, and Clinical Center (MIRECC VISN 3), James J. Peter Veterans Affairs Medical Center, Bronx, NY, United States
| | - Fiona S Graff
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Mental Illness Research, Education, and Clinical Center (MIRECC VISN 3), James J. Peter Veterans Affairs Medical Center, Bronx, NY, United States
| | - Margaret M McClure
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Mental Illness Research, Education, and Clinical Center (MIRECC VISN 3), James J. Peter Veterans Affairs Medical Center, Bronx, NY, United States
| | - Jeanine C Kolaitis
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Research & Development, James J. Peters Veterans Affairs Medical Center, Bronx, NY, United States
| | - Kim E Goldstein
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Larry J Siever
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Department of Outpatient Psychiatry, James J. Peter Veterans Affairs Medical Center, Psychiatry, Bronx, NY, United States; Mental Illness Research, Education, and Clinical Center (MIRECC VISN 3), James J. Peter Veterans Affairs Medical Center, Bronx, NY, United States
| | - James H Godbold
- Department of Biostatistics, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Erin Moshier
- Department of Biostatistics, Icahn School of Medicine at Mount Sinai, New York, NY, United States
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GÜLEÇ H, ULUSOY KAYMAK S, BİLİCİ M, GANGAL A, KAYIKÇ IOĞLU T, SARI A, TAN Ü. Clinical, Neurocognitive, Structural Imaging and Dermatogliphics in Schizophrenia According to Kraepelin Criteria. Noro Psikiyatr Ars 2013; 50:256-262. [PMID: 28360552 PMCID: PMC5363444 DOI: 10.4274/npa.y6504] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2012] [Accepted: 03/26/2012] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION A century ago, Kraepelin stated that the distinctive feature of schizophrenia was progressive deterioration. Kraepelin criteria for schizophrenia are: (1) continuous hospitalization or complete dependence on others for obtaining basic necessities of life, (2) unemployment and (3) no remission for the past five years. We aimed to determine the clinical appearance and structural biological features of Kraepelinian schizophrenia. METHODS The sample consisted of 17 Kraepelinian patients, 30 non-Kraepelinian schizophrenic patients and 43 healthy controls. The Clinical Global Impressions (CGI) and the Positive and Negative Syndrome Scales (PANSS) were used for clinical assessment. The Frontal Assessment Battery (FAB) and the Verbal Fluency and Color Trail Test (CTT) were included in the cognitive battery. Brain magnetic resonance imaging and dermatoglyphic measurements were performed for structural features. RESULT Duration of illness, hospitalization, suicide attempts, admission type, presence of a stressor and treatment choice were similar between the two patient groups. Treatment resistance and family history of schizophrenia were more common in Kraepelinian patients. PANSS and CGI subscales scores were also higher in this group. Only the category fluency and CTT-I were different in Kraepelinian patients in comparison to the other patient group. Structural findings were not different between the three groups. CONCLUSION Category fluency, which was lower in Kraepelinian patients, is an important marker of a degenerative process. The collection of severe clinical symptoms, family history of psychiatric illness and nonresponse to treatment in this particular group of patients points to the need to conduct further studies including cluster analysis in methodology.
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Affiliation(s)
- Hüseyin GÜLEÇ
- Karadeniz Technical University Medical Faculty, Department of Psychiatry Clinic, Trabzon, Turkey
- Erenköy Education and Research Hospital, Department of Psychiatry Clinic, Istanbul, Turkey
| | - Semra ULUSOY KAYMAK
- Ankara Oncology Education and Research Hospital, Department of Psychiatry Clinic, Ankara, Turkey
| | - Mustafa BİLİCİ
- Karadeniz Technical University Medical Faculty, Department of Psychiatry Clinic, Trabzon, Turkey
- Erenköy Education and Research Hospital, Department of Psychiatry Clinic, Istanbul, Turkey
| | - Ali GANGAL
- Karadeniz Technical University Faculty of Engeneering, Electric Electronics Engeneering, Trabzon, Turkey
| | - Temel KAYIKÇ IOĞLU
- Karadeniz Technical University Faculty of Engeneering, Electric Electronics Engeneering, Trabzon, Turkey
| | - Ahmet SARI
- Karadeniz Technical University, Department of Radiology, Trabzon, Turkey
| | - Üner TAN
- Çukurova University Medical Faculty, Department of Physiology, Adana, Turkey
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Keshavan MS, Eack SM, Wojtalik JA, Prasad KMR, Francis AN, Bhojraj TS, Greenwald DP, Hogarty SS. A broad cortical reserve accelerates response to cognitive enhancement therapy in early course schizophrenia. Schizophr Res 2011; 130:123-9. [PMID: 21645997 PMCID: PMC3209759 DOI: 10.1016/j.schres.2011.05.001] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2011] [Revised: 04/28/2011] [Accepted: 05/01/2011] [Indexed: 01/31/2023]
Abstract
OBJECTIVES Cognitive rehabilitation can improve cognition in schizophrenia and prevent disability. It is unknown, however, whether a greater neurobiologic reserve, as measured by cortical volumes, will predict a favorable response to rehabilitation. We investigated this question in early course schizophrenia patients treated with Cognitive Enhancement Therapy (CET). METHODS Outpatients in the early course of schizophrenia or schizoaffective disorder were randomly assigned to CET (n=29) or an Enriched Supportive Therapy control (n=21) and treated for two years. Cortical surface area and gray matter volume data were collected before treatment using structural magnetic resonance imaging. Neurocognition and social cognition were assessed before, and after one and two years of treatment. Moderator analyses examined the impact of pre-treatment cortical surface area and gray matter volume on differential neurocognitive and social-cognitive response to CET. RESULTS Pre-treatment, whole brain cortical surface area and gray matter volume significantly moderated the effects of CET on social cognition, but not neurocognition. Greater neurobiologic reserve predicted a rapid social-cognitive response to CET in the first year of treatment; patients with less neurobiologic reserve achieved a comparable social-cognitive response by the second year. While nearly every regional measurement significantly contributed to this accelerated social-cognitive treatment response, effects were the strongest in the temporal cortex. CONCLUSIONS A broad cortical surface area and gray matter reserve is associated with an accelerated social-cognitive response to CET in early schizophrenia, yet the benefits of cognitive rehabilitation are achieved in those with less initial cognitive resources after a longer duration of treatment.
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Affiliation(s)
- Matcheri S Keshavan
- Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA 02215, USA.
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Molina V, Hernández JA, Sanz J, Paniagua JC, Hernández AI, Martín C, Matías J, Calama J, Bote B. Subcortical and cortical gray matter differences between Kraepelinian and non-Kraepelinian schizophrenia patients identified using voxel-based morphometry. Psychiatry Res 2010; 184:16-22. [PMID: 20832256 DOI: 10.1016/j.pscychresns.2010.06.006] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2009] [Revised: 05/31/2010] [Accepted: 06/10/2010] [Indexed: 11/26/2022]
Abstract
The long-term outcome of schizophrenia patients may differ depending on their brain structure. This would be reflected in significant structural differences between poor-outcome (i.e., Kraepelinian) and non-Kraepelinian patients. To assess this possibility, we have evaluated the degree of deviation in brain structure in Kraepelinian patients with respect to controls and non-Kraepelinian schizophrenia patients. We used voxel-brain morphometry (VBM) to assess the differences in gray matter volume across the brain in the Kraepelinian group with respect to the healthy controls and non-Kraepelinian patients. Twenty-six Kraepelinian and 18 non-Kraepelinian schizophrenia patients and 41 healthy controls were included. With respect to the healthy controls, the Kraepelinian patients showed a very significant decrease in gray matter in the frontal, occipital, and limbic cortices, and, at a subcortical level, bilaterally in the striatum and thalamus. In comparison with the non-Kraepelinian patients, the Kraepelinian individuals continued to show a similar subcortical decrease. Thus, Kraepelinian patients may be characterized by a distinct pattern of brain abnormalities, in particular, in subcortical regions.
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Affiliation(s)
- Vicente Molina
- Servicio de Psiquiatría, Hospital Universitario de Salamanca, Salamanca, Spain.
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Altar CA, Hunt RA, Jurata LW, Webster MJ, Derby E, Gallagher P, Lemire A, Brockman J, Laeng P. Insulin, IGF-1, and muscarinic agonists modulate schizophrenia-associated genes in human neuroblastoma cells. Biol Psychiatry 2008; 64:1077-87. [PMID: 18973876 DOI: 10.1016/j.biopsych.2008.08.031] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2007] [Revised: 08/20/2008] [Accepted: 08/20/2008] [Indexed: 01/03/2023]
Abstract
BACKGROUND Genes associated with energy metabolism are decreased in schizophrenia brain and human and rodent diabetic skeletal muscle. These and other similarities between diabetes and schizophrenia suggest that an insulin signaling deficit may underlie schizophrenia. We determined with human SH-SY5Y neuroblastoma and astrocyte cell lines whether insulin or other molecules could modulate genes opposite to their change reported in schizophrenia brain. METHODS Both cell lines were treated with insulin, insulin-like growth factor (IGF)-1, IGF-2, or brain-derived neurotrophic factor (BDNF). Genes whose expression was found with microarrays to be changed by insulin in a reciprocal manner to their change in schizophrenia were used in a 16-gene miniarray to identify small molecules that might mimic insulin. RESULTS Insulin phosphorylated its receptor in the neuroblastoma cells but not in astrocytes and, like IGF-1, increased ERK1/2 and Akt phosphorylation. Insulin and IGF-1 increased the expression of genes decreased in schizophrenia, including those involved in mitochondrial functions, glucose and energy metabolism, hydrogen ion transport, and synaptic function. These gene effects were confirmed and shown to be dose related with the 16-gene miniarrays. Most of 1940 pharmacologically unique compounds failed to alter gene expression, with the exception of muscarinic agonists, which mimicked insulin and IGF-1, and which were blocked by the muscarinic antagonists atropine and telenzepine. CONCLUSIONS Stimulation of muscarinic and insulin/IGF-1 receptors alter genes associated with metabolic and synaptic functions in a manner reciprocal to their changes in schizophrenia. Pharmacologic activation of these receptors may normalize genomic alterations in schizophrenia and better address root causes of this disease.
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Bralet MC, Ton T, Falissard B. Schizophrenic patients with polydipsia and water intoxication more often have a form of schizophrenia first described by Kraepelin. Psychiatry Res 2007; 152:267-71. [PMID: 17445907 DOI: 10.1016/j.psychres.2006.11.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2005] [Revised: 10/12/2006] [Accepted: 11/19/2006] [Indexed: 11/20/2022]
Abstract
Polydipsia and water intoxication (PWI) seem to be associated with a particular form of schizophrenia, first described by Kraepelin, involving negative symptoms, disorganization and poor outcome. In this study, a group of 20 schizophrenic patients with PWI was selected and matched for age, duration of illness and gender with a group of 20 schizophrenic controls with no PWI. For these patients the following measure were obtained: clinical and demographic data, Keefe's criteria for Kraepelinian schizophrenia, the Positive and Negative Syndrome Scale score and the score on Fagerström's Nicotine Dependence Scale. The group of schizophrenic patients with PWI presents significantly higher levels of negative symptoms, disorganized symptoms and general symptoms of psychopathology, and it is composed of a significantly higher percentage of Kraepelinian patients. These results show an association of polydipsia and water intoxication with Kraepelinian schizophrenia suggesting physiological hypotheses for a specific pathogenic pathway.
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Affiliation(s)
- Marie-Cecile Bralet
- Department of Psychiatry (Fitz-James 5), Clermont de l'Oise Mental Health Hospital, 2 rue des finets, 60600 Clermont de l'Oise, France.
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Abstract
In spite of significant advances in treatment of patients with schizophrenia and continued efforts towards their deinstitutionalization, a considerable group of patients remain chronically hospitalized or otherwise dependent on others for basic necessities of life. It has been proposed that these patients belong to a distinct etiopathological subgroup, termed Kraepelinian, whose course of illness may be progressive and resistant to treatment. Indeed, longitudinal studies appear to show that elderly Kraepelinian patients follow a course of rapid cognitive and functional deterioration, commensurate with a dementing process, and that their poor functional status is closely correlated with the cognitive deterioration. Recent neuroimaging studies described a pattern of posteriorization of grey and white matter deficits with poor outcome in schizophrenia, and produced a constellation of findings implicating primary processing of visual and auditory information as central to the impaired functional status in this patient group. These studies are summarized in detail in this review and future directions for neuroimaging assessment of very poor outcome patients with schizophrenia are suggested.
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Affiliation(s)
- Serge A Mitelman
- Medical Center, Department of Psychiatry, Mount Sinai School of Medicine, One Gustave L. Levy Place, New York, NY 10029, USA.
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Mitelman SA, Brickman AM, Shihabuddin L, Newmark RE, Hazlett EA, Haznedar MM, Buchsbaum MS. A comprehensive assessment of gray and white matter volumes and their relationship to outcome and severity in schizophrenia. Neuroimage 2007; 37:449-62. [PMID: 17587598 PMCID: PMC1994089 DOI: 10.1016/j.neuroimage.2007.04.070] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2006] [Revised: 04/17/2007] [Accepted: 04/30/2007] [Indexed: 10/23/2022] Open
Abstract
Preliminary data suggest an association of posterior cortical gray matter reduction with poor outcome in schizophrenia. We made a systematic MRI assessment of regional gray and white matter volumes, parcellated into 40 Brodmann's areas, in 104 patients with schizophrenia (51 with good outcomes, 53 with poor outcomes) and 41 normal comparison subjects, and investigated correlations of regional morphometry with outcome and severity of the illness. Schizophrenia patients displayed differential reductions in frontal and to a lesser degree temporal gray matter volumes in both hemispheres, most pronounced in the frontal pole and lateral temporal cortex. White matter volumes in schizophrenia patients were bilaterally increased, primarily in the frontal, parietal, and isolated temporal regions, with volume reductions confined to anterior cingulate gyrus. In patients with schizophrenia as a group, higher illness severity was associated with reduced temporal gray matter volumes and expanded frontal white matter volumes in both hemispheres. In comparison to good-outcome group, patients with poor outcomes had lower temporal, occipital, and to a lesser degree parietal gray matter volumes in both hemispheres and temporal, parietal, occipital, and posterior cingulate white matter volumes in the right hemisphere. While gray matter deficits in the granular cortex were observed in all schizophrenia patients, agranular cortical deficits in the left hemisphere were peculiar to patients with poor outcomes. These results provide support for frontotemporal gray matter reduction and frontoparietal white matter expansion in schizophrenia. Poor outcome is associated with more posterior distribution (posteriorization) of both gray and white matter changes, and with preferential impairment in the unimodal visual and paralimbic cortical regions.
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Affiliation(s)
- Serge A Mitelman
- Department of Psychiatry, Neuroscience Positron Emission Tomography Laboratory, Box 1505, Mount Sinai Medical Center, One Gustave L. Levy Place, New York, NY 10029, USA.
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Mitelman SA, Newmark RE, Torosjan Y, Chu KW, Brickman AM, Haznedar MM, Hazlett EA, Tang CY, Shihabuddin L, Buchsbaum MS. White matter fractional anisotropy and outcome in schizophrenia. Schizophr Res 2006; 87:138-59. [PMID: 16854563 DOI: 10.1016/j.schres.2006.06.016] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2006] [Revised: 06/03/2006] [Accepted: 06/07/2006] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Disparate white matter fractional anisotropy (FA) findings have been reported in patients with schizophrenia in recent years. This may in part reflect heterogeneity of subjects in the studies, including differences in outcome and severity of the illness. We examined whether there is a relationship between white matter FA and outcome in patients with schizophrenia. METHOD Diffusion-tensor images were obtained in 41 normal subjects and 104 patients with schizophrenia, divided into good-outcome (n=51) and poor-outcome (Kraepelinian; n=53) subtypes based on their ability for self-care. White matter FA and its relationship to regional tissue volumes were evaluated across 40 individual Brodmann's areas using a semi-automated parcellation technique. RESULTS Overall white matter FA was lower in schizophrenia patients than normal subjects, with regional reductions in widespread temporoparietal and selected prefrontal white matter regions. In schizophrenia patients, lower regional white matter FA was associated with lower regional gray matter volumes. In comparison to normal subjects, overall white matter FA was reduced in patients with poor outcomes in both hemispheres, but to a lesser extent and only in the right hemisphere in good-outcome patients. Lower regional FA was associated with larger regional white matter volumes in good-outcome group. CONCLUSIONS Global FA reductions implicate white matter as tissue type in the pathophysiology of schizophrenia. In contrast to poor outcome, good outcome in schizophrenia patients may be associated with less extensive FA reductions, higher FA in regional frontal and cingulate white matter, and correlated increases in regional white matter volumes, particularly in the left hemisphere.
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Affiliation(s)
- Serge A Mitelman
- Department of Psychiatry, Neuroscience-PET Laboratory, Box 1505, Mount Sinai Medical Center, One Gustave L. Levy Place, New York, NY 10029, USA.
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Koo MS, Levitt JJ, McCarley RW, Seidman LJ, Dickey CC, Niznikiewicz MA, Voglmaier MM, Zamani P, Long KR, Kim SS, Shenton ME. Reduction of caudate nucleus volumes in neuroleptic-naïve female subjects with schizotypal personality disorder. Biol Psychiatry 2006; 60:40-8. [PMID: 16460694 PMCID: PMC2768064 DOI: 10.1016/j.biopsych.2005.09.028] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2005] [Revised: 09/22/2005] [Accepted: 09/26/2005] [Indexed: 11/16/2022]
Abstract
BACKGROUND The caudate nucleus might contribute to the psychopathological and cognitive deficits observed in schizotypal personality disorder (SPD), a schizophrenia spectrum disorder. Here we focused on female patients, because this group is underrepresented in studies of SPD and schizophrenia, and we might learn more about the caudate and clinical and cognitive impairments that are unique to female patients diagnosed with SPD. METHODS Magnetic resonance imaging scans, obtained on a 1.5-T magnet with 1.5-mm contiguous slices, were used to measure the caudate in 32 neuroleptic-naïve women with SPD and in 29 female normal comparison subjects. Subjects were group-matched for age, parental socioeconomic status, and intelligence quotient. RESULTS We found significantly reduced left and right caudate relative volume (8.3%, 7.7%) in female SPD subjects compared with normal comparison subjects. In female SPD subjects, we found significant correlations between smaller total caudate relative volume and worse performance on the Wisconsin Card Sorting test (nonperseverative errors) and on the California Verbal Learning Test (verbal memory and learning), and significant correlations between smaller total caudate relative volume and both positive and negative symptoms on the Structured Interview for Schizotypy. CONCLUSIONS These findings demonstrate that, for female SPD subjects, smaller caudate volume is associated with poorer cognitive performance and more schizotypal symptomatology.
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Affiliation(s)
- Min-Seong Koo
- Clinical Neuroscience Division, Laboratory of Neuroscience, Department of Psychiatry, Veterans Affairs Boston Healthcare System, Brockton Division, Brockton, and Harvard Medical School, Boston, MA 02401, USA
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Prasad KMR, Sahni SD, Rohm BR, Keshavan MS. Dorsolateral prefrontal cortex morphology and short-term outcome in first-episode schizophrenia. Psychiatry Res 2005; 140:147-55. [PMID: 16256315 DOI: 10.1016/j.pscychresns.2004.05.009] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2003] [Revised: 04/16/2004] [Accepted: 05/27/2004] [Indexed: 11/30/2022]
Abstract
Several clinical predictors of outcome in schizophrenia have been described; however, very few studies have examined neurobiological factors that predict outcome. The objective of this study was to examine the value of the morphology of the dorsolateral prefrontal cortex (DLPFC) determined by magnetic resonance imaging (MRI) as a predictor of short-term functional outcome in antipsychotic-naive patients with first-episode schizophrenia or schizoaffective disorder. Twenty-seven consecutive patients with first-episode schizophrenia or schizoaffective disorder underwent structural MRI at baseline. Functional outcome - a composite measure of social and employment subscales of the Strauss-Carpenter Scale - was assessed at 1 and 2 years. Volume of the left DLPFC at baseline predicted functional outcome in schizophrenia at 1 but not at 2 years. Specific cognitive functions regulated by the left DLPFC may be critical for functional outcome.
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Affiliation(s)
- Konasale M R Prasad
- Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA
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Suzuki M, Nohara S, Hagino H, Takahashi T, Kawasaki Y, Yamashita I, Watanabe N, Seto H, Kurachi M. Prefrontal abnormalities in patients with simple schizophrenia: structural and functional brain-imaging studies in five cases. Psychiatry Res 2005; 140:157-71. [PMID: 16243494 DOI: 10.1016/j.pscychresns.2005.06.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2004] [Revised: 03/24/2005] [Accepted: 06/01/2005] [Indexed: 11/29/2022]
Abstract
Simple schizophrenia is an uncommon disorder with unknown pathophysiology, and its position in the current diagnostic system is ambiguous. Brain-imaging studies may help to elucidate its pathophysiology. Five patients fulfilling both ICD-10 criteria for simple schizophrenia and DSM-IV criteria for simple deteriorative disorder underwent computed tomography, magnetic resonance imaging, and single photon emission computed tomography. These scans were assessed individually by visual inspection as well as automatically by comparison with scans in normal controls or other schizophrenia subtype patients using voxel-based image analyses. Three of the five simple schizophrenia patients had findings of atrophy and reduced cerebral perfusion in the frontal areas. Voxel-based analyses also showed prefrontal grey matter deficits and hypoperfusion in simple schizophrenia patients compared with the controls. Although this study is limited by the small number of patients with simple schizophrenia, the results suggest that simple schizophrenia, or at least this subpopulation, may have rather homogeneous morphological and functional deficits in the prefrontal cortex. It is also suggested that simple schizophrenia may occupy an extreme position of the schizophrenic continuum where the prefrontal deficits and negative symptoms are most purely manifested.
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Affiliation(s)
- Michio Suzuki
- Department of Neuropsychiatry, Toyama Medical and Pharmaceutical University, 2630 Sugitani, Toyama 930-0194, Japan.
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Davis CE, Jeste DV, Eyler LT. Review of longitudinal functional neuroimaging studies of drug treatments in patients with schizophrenia. Schizophr Res 2005; 78:45-60. [PMID: 15979287 DOI: 10.1016/j.schres.2005.05.009] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2004] [Revised: 05/02/2005] [Accepted: 05/09/2005] [Indexed: 11/29/2022]
Abstract
We systematically reviewed twenty-one functional neuroimaging studies that used longitudinal designs to investigate the effects of medication treatments on brain functioning among patients with schizophrenia. The studies reviewed were comprised of functional magnetic resonance imaging and positron emission tomography research using a baseline and at least one follow-up. The present review summarizes the different effects of medication and disease status on brain function, with attention to functional normalization, specific drug effects, and comparisons of typical versus atypical antipsychotics. Particular emphasis is given to methodological limitations in the existing literature, including lack of reliability data, clinical heterogeneity among studies, and inadequate study designs and statistics. Suggestions are made for improving future longitudinal neuroimaging studies of treatment effects in schizophrenia.
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Affiliation(s)
- C Ervin Davis
- Department of Psychiatry, University of California San Diego, USA
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Altar CA, Jurata LW, Charles V, Lemire A, Liu P, Bukhman Y, Young TA, Bullard J, Yokoe H, Webster MJ, Knable MB, Brockman JA. Deficient hippocampal neuron expression of proteasome, ubiquitin, and mitochondrial genes in multiple schizophrenia cohorts. Biol Psychiatry 2005; 58:85-96. [PMID: 16038679 DOI: 10.1016/j.biopsych.2005.03.031] [Citation(s) in RCA: 232] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2004] [Revised: 01/26/2005] [Accepted: 03/16/2005] [Indexed: 11/20/2022]
Abstract
BACKGROUND Hippocampal dentate granule neurons are altered in schizophrenia, but it is unknown if their gene expressions change in schizophrenia or other psychiatric diseases. METHODS Laser-captured dentate granule neurons from two groups of schizophrenia and control cases and from major depression and bipolar disease cases were examined for alterations in gene expression using complementary DNA (cDNA) microarrays and reverse transcription polymerase chain reaction (RT-PCR). RESULTS Compared with 24 control cases, the 22 schizophrenia patients in both groups revealed decreases in clusters of genes that encode for protein turnover (proteasome subunits and ubiquitin), mitochondrial oxidative energy metabolism (isocitrate, lactate, malate, nicotinamide adenine dinucleotide [NADH], and succinate dehydrogenases; cytochrome C oxidase; adenosine triphosphate [ATP] synthase), and genes associated with neurite outgrowth, cytoskeletal proteins, and synapse plasticity. These changes were not obtained in 9 bipolar cases or 10 major depression cases and were not associated with age, sex, brain weight, body weight, postmortem interval, or drug history. Brain pH contributed to the variance of some genes but was mostly independent of the disease effect. CONCLUSIONS Decreases in hippocampal neuron gene expression are consistent with brain imaging and microarray studies of the frontal cortex in schizophrenia. A mitochondrial and ubiquitin-proteasome hypofunctioning of dentate granule neurons may contribute to the deficits of schizophrenia.
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Affiliation(s)
- C Anthony Altar
- Psychiatric Genomics, Inc., Gaithersburg, Maryland 20878, USA.
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Mitelman SA, Shihabuddin L, Brickman AM, Hazlett EA, Buchsbaum MS. Volume of the cingulate and outcome in schizophrenia. Schizophr Res 2005; 72:91-108. [PMID: 15560955 DOI: 10.1016/j.schres.2004.02.011] [Citation(s) in RCA: 97] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2003] [Revised: 01/28/2004] [Accepted: 02/02/2004] [Indexed: 12/21/2022]
Abstract
BACKGROUND Previous studies indicated that schizophrenia patients have reduced frontal volumes in comparison with normal, but among schizophrenics, reduced volumes of the posterior (temporal, parietal and occipital) cortex were associated with poor outcome. We examined whether this pattern is seen within the anteroposterior arch of the cingulate gyrus. METHODS MR images were acquired in 37 schizophrenia patients (Kraepelinian, n = 13; non-Kraepelinian, n = 24) and 37 controls, and CSF, gray and white matter volumes in individual Brodmann's areas (BA) of the cingulate arch (areas 25, 24, 23, 31, 30, 29) were assessed and examined in relation to outcome. RESULTS Schizophrenia patients had significant gray matter reductions in the absolute (mm(3)) volume of Brodmann's area 24 in anterior cingulate and, when corrected for brain size, in the whole cingulate and retrosplenial (areas 29-30) cortex. White matter volumes were increased in right posterior cingulate (area 31). Schizophrenia patients also showed abnormal lateralization of white matter volumes in retrosplenial cortex (area 30) and had lower correlations between frontal and anterior cingulate regions than controls. Poor-outcome subgroup exhibited significant bilateral gray matter deficits in posterior cingulate and retrosplenial cortices compared to good-outcome patients, while no white matter increases in these areas were seen. CONCLUSIONS Poor outcome was associated with gray matter deficits in posterior cingulate while compensatory white matter increases in dorsal posterior regions may be related to better outcome. Possible consequences of this may include thought disorder, disturbance of consciousness, treatment resistance, and cognitive decline indicative of a dementing process as a superimposed or inherent part of this schizophrenia subtype.
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Affiliation(s)
- Serge A Mitelman
- Department of Psychiatry, Neuroscience-PET Laboratory, Box 1505, Mount Sinai School of Medicine, Mount Sinai Medical Center, One Gustave L. Levy Place, New York, NY 10029, USA.
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Brickman AM, Buchsbaum MS, Shihabuddin L, Byne W, Newmark RE, Brand J, Ahmed S, Mitelman SA, Hazlett EA. Thalamus size and outcome in schizophrenia. Schizophr Res 2004; 71:473-84. [PMID: 15474918 DOI: 10.1016/j.schres.2004.03.011] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2003] [Revised: 02/25/2004] [Accepted: 03/01/2004] [Indexed: 11/22/2022]
Abstract
The size of the thalamus was assessed in 106 patients with schizophrenia and 42 normal controls using high-resolution magnetic resonance imaging. The thalamus was traced at five axial levels proportionately spaced from dorsal to ventral directions. Patients with schizophrenia had significantly smaller thalamic areas at more ventral levels. Thalamic size was positively associated with frontal lobe and temporal lobe size. The effects were most marked in the patients with poorer clinical outcome (i.e., "Kraepelinian" patients). These findings are consistent with post-mortem and MRI measurement suggesting reduction in volume of the pulvinar, which occupies a large proportion of the ventral thalamus and which has prominent connections to the temporal lobe.
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Affiliation(s)
- Adam M Brickman
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY, USA.
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Di Michele V, Bolino F. [Factors leading to bad social outcome in subjects with psychosis]. EPIDEMIOLOGIA E PSICHIATRIA SOCIALE 2004; 13:146-51. [PMID: 15529820 DOI: 10.1017/s1121189x00003419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
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Frecska E, Symer C, White K, Piscani K, Kulcsar Z. Perceptional and executive deficits of chronic schizophrenic patients in attentional and intentional tasks. Psychiatry Res 2004; 126:63-75. [PMID: 15081628 DOI: 10.1016/j.psychres.2003.12.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2003] [Accepted: 12/31/2003] [Indexed: 10/26/2022]
Abstract
The present study investigated whether schizophrenic patients could develop appropriate visual orientation and motor set under precuing conditions which contrasted attentional (input selective) and intentional (output selective) information. The aim was to evaluate perceptual performance in processing visuospatial information, and executive performance in response preparation. Stimuli and/or elicited responses were controlled for selective hemispheric engagement. Age, sex and handedness matched groups of 33 chronic schizophrenic patients and 33 normal subjects were tested on choice reaction time (RT) tasks in which warning signals were manipulated regarding either where a target stimulus would occur (selective attention) or which hand to use for responding (response preparation). All subjects benefited from precued information regarding subsequent responses. However, schizophrenic patients were not able to use intentional cues as effectively as control subjects did. Interhemispheric asymmetry of spatial attention was found in patients with schizophrenia, with slowing of responses to uncued targets presented in the right visual field. There was also a decreased advantage of within-hemisphere stimulus-response conditions in the schizophrenic group. Our results support the notion that a dysfunction involving parietal and premotor areas has potential importance in the schizophrenic illness. We replicated findings which indicate that deficits of information processing in schizophrenia may affect left hemispheric mechanisms to a larger extent. The results also point toward a possible abnormal connectivity between frontal and parietal circuits in schizophrenia.
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Affiliation(s)
- Ede Frecska
- Department of Psychiatry, University of Florida, Gainesville, FL 32610, USA
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Roy MA, Lehoux C, Emond C, Laplante L, Bouchard RH, Everett J, Mérette C, Maziade M. A pilot neuropsychological study of Kraepelinian and non-Kraepelinian schizophrenia. Schizophr Res 2003; 62:155-63. [PMID: 12765756 DOI: 10.1016/s0920-9964(02)00481-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE This is the first study to report a direct comparison of neuropsychological performance in Kraepelinian vs. non-Kraepelinian schizophrenia (SZ). METHODS 17 Kraepelinian and 19 non-Kraepelinian subjects were assessed on a neuropsychological battery including the Purdue Pegboard, Schwartz' Reaction Time task, the Modified Card Sorting Test, the Wechsler's Associate Learning Test and the Digit Span. RESULTS Kraepelinian schizophrenia was characterized by more impaired performance on the Purdue Pegboard and the Card Sorting test. These differences remained significant when introducing, as covariates, the type of neuroleptic used, the use of anticholinergic medication, age and gender. Differences on the Reaction Time, the Associate Learning and the Digit Span tasks did not reach statistical significance. CONCLUSIONS These results suggest that Kraepelinian schizophrenia is characterized by impaired performance on fine motor dexterity and executive functioning. These results further add to the evidence for the validity of the distinction between Kraepelinian and non-Kraepelinian schizophrenia as a strategy to better understand the factors influencing severity and/or outcome in schizophrenia.
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Affiliation(s)
- Marc-André Roy
- Centre de recherche Université Laval Robert-Giffard, 2601 de la Canardière, Beauport, P Québec, Canada G1J 2G3.
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